Retinol: blitz lines, blemishes and pigmentation

As I've told you a zillion times, I had terrible acne in my early teens and was on prescription Accutane (retinol or vitamin A) supplements to treat it. It worked. I have been absolutely strict about using skincare that genuinely works - without being aggressive and leaving skin damaged - ever since.
Many retinol products - or even products SAYING they have retinol in them! - are either really harsh and will leave the skin red, peeling or even dry and scaly, OR they have such a low concentration or ineffective formulation that you won't see any results at all.

Within weeks of use, you should notice that the skin has:

• a smoother texture, 
• definitely less blemishes; and 
• softer lines. 

I have tried so many products and there are a few I would recommend. One is prescription and the others are available via salons and online.
Medik8 does an excellent range of retinol serums and balms. This brand comes with dermatologist, beautician and clinician recommendation. I recommend that you start with Retinol 3TR (0.3%) or 6TR if you don't regularly use retinol already. At the moment, I'm using Medik8 Retinol 10TR. This will be available via Skincare Store later this month in serum form, but you can still get the 10TR balm form. This is the HIGHEST STRENGTH vitamin A. In time-release formula, it hasn't aggravated my skin and I'm pretty sensitive so I'm actually surprised (and very happy.)

I see Dr Sara Mullen at the Victorian Cosmetic Institute every 6 months for a sprinkling of botox to the forehead and on my last visit, I asked if she would be interrogated on the benefits of retinol. Thankfully, she found time between being in heavy demand at work and doing the soccer run with the kids.

Why use retinol?
Topical retinoids, derivatives of  Vitamin A, were first used in patients who were being treated for acne. These patients reported smoother skin and less wrinkles after treatment, as well as having fewer blemishes. A study followed that showed patients who used topical retinoids demonstrated improvement in sunlight-induced epidermal atrophy (skin thinning), dysplasia (abnormal skin changes), and pigmentation. Overall, topical retinoids play a key role in reducing sun damage, preventing and reducing wrinkles and controlling acne.

Retinoids work by increasing the natural turnover rate of the skin. Therefore there are less dead skin cells at the surface of the skin and less blockages as a result. This property of retinoids also means that skin texture and fine wrinkles also improve.

What age would you recommend starting?
Early 30s

What strength retinol is appropriate?
4% retinol is ideal but patients may need time to work up to this dose.

How often should you use it?
Starting slowly is important to reduce side effects.  It is recommended that it be used only twice a week in the first 2 weeks, then alternative nights for the next 2 weeks, then every night. Sunscreen is also imperative with the use of retinoids as they can initially increase sun sensitivity.

Is flaking, peeling and redness a sign of a problem?
The downside of retinoids is the possibility of causing a response known as retinoic dermatitis. Skin can appear red, flaky, lumpy, and irritated for up to one month after commencement of retinoids. If redness and irritation occurs, frequency should be reduced. Some patients cannot use retinoids every night. Dryness or flakiness alone is OK and will settle within 2 months so patients should persevere.

How long do you need to use retinol products before you see a difference?
You can start to see a difference in the skin as early as 3 months of use.

What conditions would prevent someone from safely using retinol?
Retinoids should not be used in pregnant or breastfeeding mothers, or those planning to be pregnant. Also patients with a history of facial eczema or moderate to severe rosacea due to the higher risk of irritation.